{"entity":{"id":"mantle-cell-lymphoma","kind":"cancer","name":"Mantle cell lymphoma","aka":[],"tldr":"An uncommon B-cell lymphoma driven by cyclin D1 that used to behave badly in almost everyone. BTK inhibitors, CAR-T and now BCL2 drugs have changed it from chemotherapy-plus-transplant to targeted combinations.","summary":"Mantle cell lymphoma (MCL) carries t(11;14) with cyclin D1 overexpression (SOX11-positive in classical MCL). Risk is set by MIPI, Ki-67, blastoid morphology and TP53 mutation, the last defining a group that fails chemo-immunotherapy and transplant. A leukaemic non-nodal variant behaves indolently.\n\nYounger fit patients traditionally received cytarabine-containing induction and autologous transplant with rituximab maintenance; TRIANGLE (2024) showed adding ibrutinib to induction and maintenance is at least as good as transplant, and transplant is being abandoned. Older patients receive bendamustine-rituximab or R-CHOP; ECHO (2024) added acalabrutinib to BR first line (FDA approval 2025). Relapse is treated with covalent BTK inhibitors (ibrutinib 2013, acalabrutinib 2017, zanubrutinib 2019; ibrutinib's US MCL approval was withdrawn in 2023 after SHINE), then brexucabtagene autoleucel (ZUMA-2, 2020), the non-covalent BTKi pirtobrutinib (2023), or the BCL2 inhibitor sonrotoclax (2026); venetoclax-ibrutinib (SYMPATICO) is another option. Lisocabtagene was approved for MCL in 2024.\n\nTP53-mutant MCL still does poorly with everything except CAR-T and bispecifics; glofitamab and CD20×CD3 agents are in phase 3.","asOf":"2026-09-08","wikipedia":"https://en.wikipedia.org/wiki/Mantle_cell_lymphoma","links":[{"label":"TRIANGLE (Lancet 2024)","url":"https://doi.org/10.1016/S0140-6736(24)00184-3"},{"label":"NCCN Guidelines: B-Cell Lymphomas","url":"https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1480"},{"label":"NCI PDQ: adult NHL","url":"https://www.cancer.gov/types/lymphoma/patient/adult-nhl-treatment-pdq"},{"label":"Lymphoma Action: helpline services","url":"https://lymphoma-action.org.uk/information-and-support/support-you/helpline-services"},{"label":"Lymphoma Action: questions to ask your medical team about lymphoma","url":"https://lymphoma-action.org.uk/information-and-support/tests-scans-and-lymphoma-staging/questions-ask-your-medical-team-about-lymphoma"},{"label":"Lymphoma Action: follow-up after lymphoma treatment","url":"https://lymphoma-action.org.uk/information-and-support/living-and-beyond-lymphoma/follow-after-lymphoma-treatment"},{"label":"Lymphoma Action: infections, risk and prevention","url":"https://lymphoma-action.org.uk/information-and-support/side-effects-lymphoma-and-treatment/infections-risk-and-prevention"},{"label":"Lymphoma Action: neutropenia (low neutrophils)","url":"https://lymphoma-action.org.uk/information-and-support/side-effects-lymphoma-and-treatment/neutropenia-low-neutrophils"},{"label":"Lymphoma Action: cancer-related fatigue","url":"https://lymphoma-action.org.uk/information-and-support/side-effects-lymphoma-and-treatment/cancer-related-fatigue"},{"label":"Lymphoma Action: lymphoma, work and you","url":"https://lymphoma-action.org.uk/information-and-support/living-and-beyond-lymphoma/day-day-living/lymphoma-work-and-you"},{"label":"Maggie's: support and information","url":"https://www.maggies.org/support-and-information/"},{"label":"Lymphoma Action: active monitoring (watch and wait)","url":"https://lymphoma-action.org.uk/information-and-support/lymphoma-treatment/active-monitoring-watch-and-wait"},{"label":"Lymphoma Action: CAR-T cell therapy","url":"https://lymphoma-action.org.uk/information-and-support/lymphoma-treatment/car-t-cell-therapy"},{"label":"Lymphoma Action: when lymphoma comes back, or does not respond","url":"https://lymphoma-action.org.uk/information-and-support/living-and-beyond-lymphoma/lymphoma-comes-back-relapses-or-doesnt-respond"},{"label":"Macmillan: non-Hodgkin lymphoma","url":"https://www.macmillan.org.uk/cancer-information-and-support/lymphoma/non-hodgkin-lymphoma"}],"tags":["gap-fill","haematologic"],"related":["follicular-lymphoma","marginal-zone-lymphoma","dlbcl","waldenstrom","tp53-del17p","btk-c481s","bcl2-g101v","cyclin-d1-t11-14","lymphoma-roadmap","lymphoma-ev-fixed-duration-chemotherapy-free-first-line"],"cancers":[],"sections":[],"technologies":["kinase-inhibitors","car-t","autologous-stem-cell-transplant","t-cell-engager","monoclonal-antibody","palliative-care","psycho-oncology","peer-support-groups","survivorship-care-plan","fertility-preservation","financial-navigation","cbt-fatigue-distress","exercise-during-chemotherapy","multidisciplinary-tumour-board","oncology-nutrition","prehabilitation","bispecific-antibody","cytogenetics-fish","histopathology-ihc","cgp","clonality-testing"],"targets":["btk","bcl2","cd19","cd20","cd3","cdk4-6","ccnd1","tp53","atm","plcg2","notch1","notch2","kmt2d","birc3","cdkn2a"],"drugs":["ibrutinib","acalabrutinib","zanubrutinib","pirtobrutinib","brexucabtagene-autoleucel","lisocabtagene-maraleucel","sonrotoclax","venetoclax","bendamustine","rituximab","glofitamab","clonoseq","bortezomib"],"companies":["abbvie","astrazeneca","beone","gilead","eli-lilly","bms"],"institutions":[],"pathways":["apoptosis-bcl2","p53-cell-cycle","cell-cycle-engine-cdks","bcr-signalling","p53-mdm2-axis"],"terms":["del17p-tp53","mrd","lugano-classification","mipi","cyclin-d1-t11-14","lymphoma-tx-transplant-role","lymphoma-tx-maintenance","lymphoma-tx-car-t-pathway","lymphoma-tx-crs-icans","lymphoma-tx-uk-versus-us","lymphoma-tx-regimen-alphabet","lymphoma-tx-tumour-lysis","cancer-related-fatigue","late-effects","febrile-neutropenia","neutropenia","financial-toxicity","central-venous-access","hypogammaglobulinaemia","performance-status","quality-of-life","lymphoma-decision-watch-and-wait","lymphoma-decision-local-or-car-t-centre","lymphoma-decision-trial","lymphoma-living-indolent-lymphoma","lymphoma-living-infection-years-after","lymphoma-living-vaccinations","lymphoma-living-fatigue","watchful-waiting","lymphoma-bio-antigen-escape","lymphoma-bio-germinal-centre","resistance","cross-resistance"],"trials":["nct07377578","nct04002297","nct01804686","nct06742996","nct06363994","nct04662255","nct02972840","zuma-2","triangle","sympatico","shine","enrich","lyma"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":["Living with mantle cell lymphoma: This is orientation from public patient pages, guidelines and the trials themselves, not advice for your case: your own team's instructions and the 24-hour number they gave you come first, and no figure here is a prediction about you. The decision records, the question sets, the first 60 days checklist and the red cards on this page were written from the NHS, Lymphoma Action, Macmillan and Cancer Research UK patient pages, from NICE NG52, NG47, CG151 and NG234, from the NHS Breast Screening Programme protocols and the Green Book, and from the trial reports named beside each figure, all read on 1 October 2026."],"group":"haematologic","burden":"Mantle cell lymphoma makes up about 5-7% of non-Hodgkin lymphomas; incidence ~1 per 100,000 per year, median age ~68, 3:1 male.","subtypes":["Classical nodal MCL (SOX11+)","Leukaemic non-nodal MCL (indolent)","Blastoid / pleomorphic variant","TP53-mutant MCL","In situ mantle cell neoplasia"],"biomarkers":["t(11;14) / cyclin D1 IHC","SOX11","MIPI and MIPI-c","Ki-67 (≥30% high risk)","TP53 mutation / del(17p)","Blastoid morphology","MRD (ctDNA/clonoSEQ, investigational)"],"standardOfCare":[{"setting":"First line, fit (<65-70)","approach":"Rituximab + high-dose cytarabine-based induction (e.g. R-CHOP/R-DHAP or Nordic) with ibrutinib and 2 years ibrutinib maintenance; autologous transplant no longer adds benefit when ibrutinib is used (TRIANGLE).","refs":["rituximab","ibrutinib","autologous-stem-cell-transplant","triangle"],"guideline":{"nccn":"Category 2A","version":"NCCN Guidelines: B-Cell Lymphomas","url":"https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1480"}},{"setting":"First line, older or unfit","approach":"Bendamustine-rituximab + acalabrutinib (ECHO, approved 2025) or BR alone with rituximab maintenance; R-CHOP alternative.","refs":["bendamustine","rituximab","acalabrutinib"],"guideline":{"nccn":"Category 1 (BR + acalabrutinib)","version":"NCCN Guidelines: B-Cell Lymphomas"}},{"setting":"Relapsed, BTKi-naive","approach":"Covalent BTK inhibitor (acalabrutinib, zanubrutinib; ibrutinib ex-US) ± venetoclax (SYMPATICO).","refs":["acalabrutinib","zanubrutinib","ibrutinib","venetoclax","sympatico"],"guideline":{"nccn":"Category 2A","version":"NCCN Guidelines: B-Cell Lymphomas"}},{"setting":"Relapsed after BTKi","approach":"Brexucabtagene or lisocabtagene CAR-T; pirtobrutinib; sonrotoclax (2026); allogeneic HSCT in selected patients; bispecific trials.","refs":["brexucabtagene-autoleucel","lisocabtagene-maraleucel","pirtobrutinib","sonrotoclax","allogeneic-hsct"],"guideline":{"nccn":"Category 2A","version":"NCCN Guidelines: B-Cell Lymphomas"}},{"setting":"Mantle cell lymphoma: the three things to establish before choosing treatment","approach":"Mantle cell lymphoma is not one disease. Classical nodal disease behaves aggressively and needs treatment. Leukaemic non-nodal mantle cell lymphoma, with SOX11-negative, hypermutated immunoglobulin genes, splenomegaly and circulating cells but no lymphadenopathy, can be watched for years, and treating it early does harm without benefit. Blastoid and pleomorphic variants behave much more aggressively.\n\nThree things to establish. First, the growth pattern and Ki-67 index: above about 30 per cent signals aggressive disease. Second, TP53 mutation status, which is the single strongest adverse factor and predicts poor response to intensive chemotherapy and to autologous transplant; a TP53-mutated patient is a candidate for a novel-agent regimen or a trial rather than for intensification. Third, the MIPI score, which combines age, performance status, LDH and white cell count. Gastrointestinal involvement is near-universal at a microscopic level and colonoscopy is not required in every patient.","refs":["mipi","lymphoma-tx-watch-and-wait","lymphoma-tx-regimen-alphabet","fdg-pet"],"guideline":{"version":"NCCN B-Cell Lymphomas; ESMO; BSH","url":"https://www.cancer.gov/types/lymphoma/hp/adult-nhl-treatment-pdq"}},{"setting":"First-line mantle cell lymphoma in younger, fitter patients after TRIANGLE: ibrutinib in, transplant optional","approach":"TRIANGLE randomised 870 patients up to 65 who were fit for transplant to three arms: alternating R-CHOP and R-DHAP induction with autologous transplant (arm A); the same with ibrutinib added to induction and as two-year maintenance (arm A+I); or ibrutinib-containing induction and maintenance without transplant (arm I). Three-year failure-free survival was 88 per cent for arm A+I against 72 per cent for arm A (hazard ratio 0.52). Transplant was not shown to be superior to the ibrutinib-containing regimen without it: 72 per cent for arm A against 86 per cent for arm I. Adding ibrutinib to transplant increased grade 3 to 5 haematological events during maintenance and follow-up (50 per cent in arm A+I against 21 per cent in arm A) and infections (25 against 13 per cent).\n\nWhat changed in practice: a covalent BTK inhibitor belongs in first-line treatment of younger patients, and autologous transplant is no longer automatic. Many units now give ibrutinib-containing induction and maintenance without transplant, particularly in TP53-mutated disease where transplant has never worked well. Where transplant is used, rituximab maintenance afterwards improves survival: LyMa randomised 240 patients after transplant to three years of rituximab or observation and found four-year event-free survival of 79 against 61 per cent, with overall survival also improved.\n\nCytarabine-containing induction (R-DHAP or the Nordic regimen) remains the backbone where an intensive approach is chosen. In England, NICE TA1193 allows exactly the TRIANGLE schedule: ibrutinib with R-CHOP alternating with R-DHAP or R-DHAOx, followed by ibrutinib alone, for untreated disease in adults for whom an autologous transplant is suitable.","refs":["triangle","ibrutinib","rituximab","cytarabine","cisplatin","dexamethasone","oxaliplatin","r-chop","autologous-stem-cell-transplant","lymphoma-tx-transplant-role","lymphoma-tx-maintenance","lymphoma-tx-uk-access","mipi","paper-triangle-ibrutinib-mantle-cell-lymphoma-dreyling-lancet-2024"],"guideline":{"version":"NCCN B-Cell Lymphomas; ESMO; TRIANGLE, LyMa","url":"https://doi.org/10.1056/NEJMoa1701769"}},{"setting":"First-line mantle cell lymphoma in older patients: the British answer and the international one","approach":"Two randomised trials, two different regimens, and a real difference between British and American practice.\n\nENRICH, run at 66 sites in the United Kingdom and the Nordic countries, randomised 397 patients aged 60 and over to ibrutinib with rituximab or to the investigator's choice of immunochemotherapy (R-CHOP or bendamustine-rituximab), both followed by two years of rituximab maintenance, with ibrutinib continued until progression. At a median follow-up of 47.9 months the adjusted hazard ratio for progression-free survival was 0.69 in favour of ibrutinib-rituximab. The benefit was concentrated where the comparator was R-CHOP (hazard ratio 0.37) and was not demonstrated against bendamustine-rituximab (0.91). Grade 3 or worse adverse events were similar (67 against 70 per cent). This is the first randomised trial in untreated mantle cell lymphoma to show a chemotherapy-free combination beating immunochemotherapy, and it is British practice.\n\nSHINE took the other route and added ibrutinib to bendamustine-rituximab in 523 patients aged 65 and over: median progression-free survival 80.6 against 52.9 months (hazard ratio 0.75) with no overall survival difference and grade 3 or 4 adverse events in 81.5 against 77.3 per cent.\n\nSo: ibrutinib-rituximab without chemotherapy for a patient in whom bendamustine is unattractive, and bendamustine-rituximab with or without a BTK inhibitor otherwise. Acalabrutinib and zanubrutinib are the second-generation covalent BTK inhibitors, with less atrial fibrillation and hypertension than ibrutinib, and are substituted in patients with cardiac risk. Acalabrutinib with bendamustine and rituximab received traditional United States approval on 16 January 2025 on the ECHO trial for untreated mantle cell lymphoma in people not eligible for an autologous transplant, and NICE TA1184 recommends the same combination in England for the same group. VR-CAP, which replaces vincristine with bortezomib, is an alternative backbone.","refs":["ibrutinib","rituximab","bendamustine","acalabrutinib","zanubrutinib","bortezomib","r-chop","lymphoma-tx-uk-versus-us","lymphoma-tx-maintenance","lymphoma-tx-regimen-alphabet"],"guideline":{"version":"NCCN B-Cell Lymphomas; ESMO; ENRICH, SHINE","url":"https://doi.org/10.1016/S0140-6736(25)01432-1"}},{"setting":"Relapsed mantle cell lymphoma that has not yet had a BTK inhibitor","approach":"A covalent BTK inhibitor is the standard next treatment and produces responses in about two thirds. Acalabrutinib and zanubrutinib are preferred over ibrutinib on cardiovascular toxicity where both are available. Adding venetoclax lengthens remission: SYMPATICO randomised 366 patients after one to five prior lines to ibrutinib with venetoclax or ibrutinib with placebo and gave median progression-free survival of 31.9 against 22.1 months (hazard ratio 0.629), with a complete response of 69.2 per cent in a separate open-label arm of treatment-naive TP53-mutated disease. Venetoclax carries a tumour lysis risk that requires a ramp-up and monitoring.\n\nOther options at this point are lenalidomide with rituximab, bortezomib-containing regimens, bendamustine with rituximab if not used before, and a clinical trial. Autologous transplant is rarely useful at relapse; allogeneic transplant is reserved for young, fit patients with chemosensitive disease.","refs":["sympatico","ibrutinib","acalabrutinib","zanubrutinib","venetoclax","lenalidomide","rituximab","bortezomib","bendamustine","lymphoma-tx-tumour-lysis","allogeneic-hsct"],"guideline":{"version":"NCCN B-Cell Lymphomas; ESMO; SYMPATICO","url":"https://www.cancer.gov/types/lymphoma/hp/adult-nhl-treatment-pdq"}},{"setting":"Mantle cell lymphoma after a BTK inhibitor has failed: brexucabtagene autoleucel and pirtobrutinib","approach":"Progression on a covalent BTK inhibitor was, until 2020, the point at which there was little left. Two treatments changed it.\n\nBrexucabtagene autoleucel, a CD19 CAR-T product, was tested in ZUMA-2 in 105 patients who had all had a BTK inhibitor: objective response 93 per cent and complete response 67 per cent in the primary efficacy analysis, 85 per cent by intention to treat, with progression-free survival of 61 per cent and overall survival of 83 per cent at twelve months. The toxicity is real: grade 3 or higher cytokine release syndrome in 15 per cent and grade 3 or higher neurological events in 31 per cent, higher than the CD19 products used in large B-cell lymphoma. Referral should happen as the BTK inhibitor starts to fail, not after the next line, because apheresis quality falls with further treatment.\n\nPirtobrutinib, a non-covalent BTK inhibitor, works after covalent BTK inhibitor failure including in the presence of the C481S resistance mutation, and is an option for patients who are not candidates for CAR-T or who need disease control while a CAR-T product is manufactured.\n\nLisocabtagene maraleucel is the second CAR-T option, approved in the United States on 30 May 2024 for relapsed or refractory mantle cell lymphoma after at least two prior lines including a BTK inhibitor. Other options are venetoclax-based combinations, glofitamab with pirtobrutinib in a trial, allogeneic transplant in selected younger patients, and palliative radiotherapy to a symptomatic site. This is a point at which a trial is often the best available treatment.","refs":["zuma-2","brexucabtagene-autoleucel","lisocabtagene-maraleucel","pirtobrutinib","venetoclax","glofitamab","car-t","lymphoma-tx-car-t-pathway","lymphoma-tx-crs-icans","allogeneic-hsct","palliative-radiotherapy","paper-zuma-2-brexu-cel-mantle-cell-nejm-2020"],"guideline":{"version":"NCCN B-Cell Lymphomas; ESMO; ZUMA-2","url":"https://www.cancer.gov/types/lymphoma/hp/adult-nhl-treatment-pdq"}}],"stateOfArt":["Transplant is leaving first-line MCL: TRIANGLE made ibrutinib-containing induction and maintenance the new fit-patient standard.","BTK inhibitors sit in first line for older patients (ECHO) and at relapse; pirtobrutinib rescues covalent-BTKi failures.","CAR-T (ZUMA-2) gives long remissions after BTKi failure, including in TP53-mutant disease.","BCL2 inhibition is back: sonrotoclax approved for relapsed MCL in 2026 with venetoclax combinations close behind.","One founding translocation, and everything else is secondary. The t(11;14) puts CCND1 under the immunoglobulin heavy-chain locus and is considered the first oncogenic hit in virtually all mantle cell lymphomas. Sequencing of 29 genomes with validation in 172 more found 25 significantly mutated genes on top of it, including ATM, TP53, BIRC3, KMT2D and NOTCH2.","TP53 is the result that changes the plan. Among 183 younger patients on the Nordic protocols, TP53 mutation was present in 11% and carried a hazard ratio of 6.2 for overall survival, a median overall survival of 1.8 years against 12.7 years, half relapsing within a year, and worse responses to both induction and high-dose chemotherapy. No label depends on it, and in practice it is the usual reason to go to a BTK inhibitor, venetoclax or CAR-T rather than intensive chemotherapy and transplant.","A minority of cases are cyclin D1-negative and carry CCND2 or CCND3 rearrangements instead; SOX11 identifies most of them, and its absence marks the indolent leukaemic non-nodal form that is often watched rather than treated.","Resistance to a BTK inhibitor is read in the kinase. BTK C481S is answered by a non-covalent inhibitor; PLCG2 gain of function is not, because it sits below the drug; and L528W defeats both."],"history":[{"year":1992,"title":"Cyclin D1 and t(11;14) define MCL","note":"Mantle cell lymphoma recognised as a distinct entity (REAL classification 1994).","refs":[]},{"year":2008,"title":"MIPI prognostic index","refs":[]},{"year":2013,"title":"Ibrutinib: first BTK inhibitor approved","note":"68% response in relapsed MCL; the first indication for any BTK inhibitor.","refs":["ibrutinib"]},{"year":2017,"title":"Acalabrutinib approved (ACE-LY-004)","refs":["acalabrutinib"]},{"year":2019,"title":"Zanubrutinib approved","refs":["zanubrutinib"]},{"year":2020,"title":"Brexucabtagene autoleucel (ZUMA-2)","note":"First CAR-T for MCL: 93% response after BTKi failure.","refs":["brexucabtagene-autoleucel"]},{"year":2023,"title":"Pirtobrutinib approved; ibrutinib US MCL indication withdrawn","refs":["pirtobrutinib","ibrutinib"]},{"year":2024,"title":"TRIANGLE and ECHO","note":"Ibrutinib replaces transplant in fit patients; acalabrutinib + BR improves PFS first line in older patients.","refs":["ibrutinib","acalabrutinib"]},{"year":2026,"title":"Sonrotoclax approved for relapsed MCL","refs":["sonrotoclax"]}],"pipeline":["sonrotoclax","glofitamab","pirtobrutinib","venetoclax","bgb-16673","nemtabrutinib","rocbrutinib","icp-248","zamtocabtagene-autoleucel","ctx112"],"openProblems":["TP53-mutant and blastoid MCL fail chemo-immunotherapy; need CAR-T or bispecific-based first-line trials.","MRD-guided treatment duration.","Whether CAR-T should precede pirtobrutinib or follow it.","Cost and access of indefinite BTK-inhibitor therapy.","TRIANGLE showed that adding ibrutinib to induction and maintenance improves failure-free survival and that transplant is not superior to an ibrutinib-containing regimen without it, but it did not answer which of the three arms is best for a given patient, and the arm that omits transplant has the shortest follow-up.","TP53-mutated mantle cell lymphoma responds poorly to every intensive chemotherapy strategy tested, including autologous transplant, and there is no regimen with randomised evidence in this group.","ENRICH showed ibrutinib-rituximab beats R-CHOP in older patients but not bendamustine-rituximab, so the right first treatment for an older patient depends on which comparator a clinician would otherwise have chosen, which is an uncomfortable basis for a recommendation."],"parent":"non-hodgkin-lymphoma"},"route":"/cancers/mantle-cell-lymphoma/","neighbours":{"cancer":[{"id":"dlbcl","kind":"cancer","name":"Diffuse large B-cell lymphoma","route":"/cancers/dlbcl/"},{"id":"follicular-lymphoma","kind":"cancer","name":"Follicular lymphoma","route":"/cancers/follicular-lymphoma/"},{"id":"marginal-zone-lymphoma","kind":"cancer","name":"Marginal zone lymphoma","route":"/cancers/marginal-zone-lymphoma/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"},{"id":"peripheral-t-cell-lymphoma","kind":"cancer","name":"Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma)","route":"/cancers/peripheral-t-cell-lymphoma/"},{"id":"splenic-b-cell-lymphoma-leukaemia-prominent-nucleoli","kind":"cancer","name":"Splenic B-cell lymphoma/leukaemia with prominent nucleoli (formerly B-cell prolymphocytic leukaemia and hairy cell leukaemia variant)","route":"/cancers/splenic-b-cell-lymphoma-leukaemia-prominent-nucleoli/"},{"id":"waldenstrom","kind":"cancer","name":"Waldenström macroglobulinaemia","route":"/cancers/waldenstrom/"}],"biomarker":[{"id":"bcl2-g101v","kind":"biomarker","name":"BCL2 G101V and the other venetoclax binding-site mutations","route":"/biomarkers/bcl2-g101v/"},{"id":"btk-c481s","kind":"biomarker","name":"BTK resistance mutations: C481S, and L528W and T474I after the non-covalent inhibitors","route":"/biomarkers/btk-c481s/"},{"id":"cd19-expression","kind":"biomarker","name":"CD19 expression (CD19-positive)","route":"/biomarkers/cd19-expression/"},{"id":"cd20-expression","kind":"biomarker","name":"CD20 expression (CD20-positive)","route":"/biomarkers/cd20-expression/"},{"id":"tp53-del17p","kind":"biomarker","name":"TP53 mutation and del(17p)","route":"/biomarkers/tp53-del17p/"}],"term":[{"id":"lymphoma-decision-trial","kind":"term","name":"A clinical trial or standard treatment in lymphoma","route":"/terms/lymphoma-decision-trial/"},{"id":"lymphoma-bio-antigen-escape","kind":"term","name":"Antigen escape: how a lymphoma loses the thing the drug was aimed at","route":"/terms/lymphoma-bio-antigen-escape/"},{"id":"lymphoma-tx-uk-versus-us","kind":"term","name":"British and American lymphoma practice: where they differ, and why","route":"/terms/lymphoma-tx-uk-versus-us/"},{"id":"btki-bcl2i-resistance-mutations","kind":"term","name":"BTK C481S, PLCG2 and BCL2 G101V resistance mutations","route":"/terms/btki-bcl2i-resistance-mutations/"},{"id":"cancer-related-fatigue","kind":"term","name":"Cancer-related fatigue (tiredness)","route":"/terms/cancer-related-fatigue/"},{"id":"central-venous-access","kind":"term","name":"Central venous access (port, PICC line)","route":"/terms/central-venous-access/"},{"id":"cross-resistance","kind":"term","name":"Cross-resistance","route":"/terms/cross-resistance/"},{"id":"crs","kind":"term","name":"Cytokine release syndrome (CRS)","route":"/terms/crs/"},{"id":"lymphoma-tx-crs-icans","kind":"term","name":"Cytokine release syndrome and ICANS: grading and management","route":"/terms/lymphoma-tx-crs-icans/"},{"id":"deauville","kind":"term","name":"Deauville score and PET-adapted therapy","route":"/terms/deauville/"},{"id":"del17p-tp53","kind":"term","name":"del(17p) / TP53 aberration in CLL","route":"/terms/del17p-tp53/"},{"id":"resistance","kind":"term","name":"Drug resistance (primary and acquired)","route":"/terms/resistance/"},{"id":"lymphoma-living-fatigue","kind":"term","name":"Fatigue after lymphoma treatment, and why it is a symptom to report","route":"/terms/lymphoma-living-fatigue/"},{"id":"febrile-neutropenia","kind":"term","name":"Febrile neutropenia","route":"/terms/febrile-neutropenia/"},{"id":"financial-toxicity","kind":"term","name":"Financial toxicity","route":"/terms/financial-toxicity/"},{"id":"lymphoma-living-returning-to-work","kind":"term","name":"Going back to work after lymphoma, and the money in the meantime","route":"/terms/lymphoma-living-returning-to-work/"},{"id":"lymphoma-tx-hepatitis-b-reactivation","kind":"term","name":"Hepatitis B reactivation before rituximab and other anti-CD20 antibodies","route":"/terms/lymphoma-tx-hepatitis-b-reactivation/"},{"id":"hypogammaglobulinaemia","kind":"term","name":"Hypogammaglobulinaemia and infection risk after B-cell 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